Noninvasive Diagnosis of Portal Hypertension in Patients With Compensated Advanced Chronic Liver Disease
We aimed to explore the prevalence of portal hypertension in the most common etiologies of patients with compensated advanced chronic liver disease (cACLD) and develop classification rules, based on liver stiffness measurement (LSM), that could be readily used to diagnose or exclude clinically signi...
Saved in:
| Published in: | The American journal of gastroenterology Vol. 116; no. 4; pp. 723 - 732 |
|---|---|
| Main Authors: | , , , , , , , , , , , , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
United States
Wolters Kluwer Health Medical Research, Lippincott Williams & Wilkins
01.04.2021
Lippincott, Williams & Wilkins |
| Subjects: | |
| ISSN: | 0002-9270, 1572-0241, 1572-0241 |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Abstract | We aimed to explore the prevalence of portal hypertension in the most common etiologies of patients with compensated advanced chronic liver disease (cACLD) and develop classification rules, based on liver stiffness measurement (LSM), that could be readily used to diagnose or exclude clinically significant portal hypertension (CSPH) in clinical practice.
This is an international cohort study including patients with paired LSM/hepatic venous pressure gradient (HVPG), LSM ≥10 kPa, and no previous decompensation. Portal hypertension was defined by an HVPG >5 mm Hg. A positive predictive value ≥90% was considered to validate LSM cutoffs for CSPH (HVPG ≥10 mm Hg), whereas a negative predictive value ≥90% ruled out CSPH.
A total of 836 patients with hepatitis C (n = 358), nonalcoholic steatohepatitis (NASH, n = 248), alcohol use (n = 203), and hepatitis B (n = 27) were evaluated. Portal hypertension prevalence was >90% in all cACLD etiologies, except for patients with NASH (60.9%), being even lower in obese patients with NASH (53.3%); these lower prevalences of portal hypertension in patients with NASH were maintained across different strata of LSM values. LSM ≥25 kPa was the best cutoff to rule in CSPH in alcoholic liver disease, chronic hepatitis B, chronic hepatitis C, and nonobese patients with NASH, whereas in obese NASH patients, the positive predictive value was only 62.8%. A new model for patients with NASH (ANTICIPATE-NASH model) to predict CSPH considering body mass index, LSM, and platelet count was developed, and a nomogram was constructed. LSM ≤15 kPa plus platelets ≥150 × 10/L ruled out CSPH in most etiologies.
Patients with cACLD of NASH etiology, especially obese patients with NASH, present lower prevalences of portal hypertension compared with other cACLD etiologies. LSM ≥25 kPa is sufficient to rule in CSPH in most etiologies, including nonobese patients with NASH, but not in obese patients with NASH. |
|---|---|
| AbstractList | INTRODUCTION:We aimed to explore the prevalence of portal hypertension in the most common etiologies of patients with compensated advanced chronic liver disease (cACLD) and develop classification rules, based on liver stiffness measurement (LSM), that could be readily used to diagnose or exclude clinically significant portal hypertension (CSPH) in clinical practice.METHODS:This is an international cohort study including patients with paired LSM/hepatic venous pressure gradient (HVPG), LSM ≥10 kPa, and no previous decompensation. Portal hypertension was defined by an HVPG >5 mm Hg. A positive predictive value ≥90% was considered to validate LSM cutoffs for CSPH (HVPG ≥10 mm Hg), whereas a negative predictive value ≥90% ruled out CSPH.RESULTS:A total of 836 patients with hepatitis C (n = 358), nonalcoholic steatohepatitis (NASH, n = 248), alcohol use (n = 203), and hepatitis B (n = 27) were evaluated. Portal hypertension prevalence was >90% in all cACLD etiologies, except for patients with NASH (60.9%), being even lower in obese patients with NASH (53.3%); these lower prevalences of portal hypertension in patients with NASH were maintained across different strata of LSM values. LSM ≥25 kPa was the best cutoff to rule in CSPH in alcoholic liver disease, chronic hepatitis B, chronic hepatitis C, and nonobese patients with NASH, whereas in obese NASH patients, the positive predictive value was only 62.8%. A new model for patients with NASH (ANTICIPATE-NASH model) to predict CSPH considering body mass index, LSM, and platelet count was developed, and a nomogram was constructed. LSM ≤15 kPa plus platelets ≥150 × 109/L ruled out CSPH in most etiologies.DISCUSSION:Patients with cACLD of NASH etiology, especially obese patients with NASH, present lower prevalences of portal hypertension compared with other cACLD etiologies. LSM ≥25 kPa is sufficient to rule in CSPH in most etiologies, including nonobese patients with NASH, but not in obese patients with NASH. INTRODUCTION: We aimed to explore the prevalence of portal hypertension in the most common etiologies of patients with compensated advanced chronic liver disease (cACLD) and develop classification rules, based on liver stiffness measurement (LSM), that could be readily used to diagnose or exclude clinically significant portal hypertension (CSPH) in clinical practice. METHODS: This is an international cohort study including patients with paired LSM/hepatic venous pressure gradient (HVPG), LSM ≥10 kPa, and no previous decompensation. Portal hypertension was defined by an HVPG >5 mm Hg. A positive predictive value ≥90% was considered to validate LSM cutoffs for CSPH (HVPG ≥10 mm Hg), whereas a negative predictive value ≥90% ruled out CSPH. RESULTS: A total of 836 patients with hepatitis C (n = 358), nonalcoholic steatohepatitis (NASH, n = 248), alcohol use (n = 203), and hepatitis B (n = 27) were evaluated. Portal hypertension prevalence was >90% in all cACLD etiologies, except for patients with NASH (60.9%), being even lower in obese patients with NASH (53.3%); these lower prevalences of portal hypertension in patients with NASH were maintained across different strata of LSM values. LSM ≥25 kPa was the best cutoff to rule in CSPH in alcoholic liver disease, chronic hepatitis B, chronic hepatitis C, and nonobese patients with NASH, whereas in obese NASH patients, the positive predictive value was only 62.8%. A new model for patients with NASH (ANTICIPATE-NASH model) to predict CSPH considering body mass index, LSM, and platelet count was developed, and a nomogram was constructed. LSM ≤15 kPa plus platelets ≥150 × 10 9 /L ruled out CSPH in most etiologies. DISCUSSION: Patients with cACLD of NASH etiology, especially obese patients with NASH, present lower prevalences of portal hypertension compared with other cACLD etiologies. LSM ≥25 kPa is sufficient to rule in CSPH in most etiologies, including nonobese patients with NASH, but not in obese patients with NASH. We aimed to explore the prevalence of portal hypertension in the most common etiologies of patients with compensated advanced chronic liver disease (cACLD) and develop classification rules, based on liver stiffness measurement (LSM), that could be readily used to diagnose or exclude clinically significant portal hypertension (CSPH) in clinical practice. This is an international cohort study including patients with paired LSM/hepatic venous pressure gradient (HVPG), LSM ≥10 kPa, and no previous decompensation. Portal hypertension was defined by an HVPG >5 mm Hg. A positive predictive value ≥90% was considered to validate LSM cutoffs for CSPH (HVPG ≥10 mm Hg), whereas a negative predictive value ≥90% ruled out CSPH. A total of 836 patients with hepatitis C (n = 358), nonalcoholic steatohepatitis (NASH, n = 248), alcohol use (n = 203), and hepatitis B (n = 27) were evaluated. Portal hypertension prevalence was >90% in all cACLD etiologies, except for patients with NASH (60.9%), being even lower in obese patients with NASH (53.3%); these lower prevalences of portal hypertension in patients with NASH were maintained across different strata of LSM values. LSM ≥25 kPa was the best cutoff to rule in CSPH in alcoholic liver disease, chronic hepatitis B, chronic hepatitis C, and nonobese patients with NASH, whereas in obese NASH patients, the positive predictive value was only 62.8%. A new model for patients with NASH (ANTICIPATE-NASH model) to predict CSPH considering body mass index, LSM, and platelet count was developed, and a nomogram was constructed. LSM ≤15 kPa plus platelets ≥150 × 10/L ruled out CSPH in most etiologies. Patients with cACLD of NASH etiology, especially obese patients with NASH, present lower prevalences of portal hypertension compared with other cACLD etiologies. LSM ≥25 kPa is sufficient to rule in CSPH in most etiologies, including nonobese patients with NASH, but not in obese patients with NASH. We aimed to explore the prevalence of portal hypertension in the most common etiologies of patients with compensated advanced chronic liver disease (cACLD) and develop classification rules, based on liver stiffness measurement (LSM), that could be readily used to diagnose or exclude clinically significant portal hypertension (CSPH) in clinical practice.INTRODUCTIONWe aimed to explore the prevalence of portal hypertension in the most common etiologies of patients with compensated advanced chronic liver disease (cACLD) and develop classification rules, based on liver stiffness measurement (LSM), that could be readily used to diagnose or exclude clinically significant portal hypertension (CSPH) in clinical practice.This is an international cohort study including patients with paired LSM/hepatic venous pressure gradient (HVPG), LSM ≥10 kPa, and no previous decompensation. Portal hypertension was defined by an HVPG >5 mm Hg. A positive predictive value ≥90% was considered to validate LSM cutoffs for CSPH (HVPG ≥10 mm Hg), whereas a negative predictive value ≥90% ruled out CSPH.METHODSThis is an international cohort study including patients with paired LSM/hepatic venous pressure gradient (HVPG), LSM ≥10 kPa, and no previous decompensation. Portal hypertension was defined by an HVPG >5 mm Hg. A positive predictive value ≥90% was considered to validate LSM cutoffs for CSPH (HVPG ≥10 mm Hg), whereas a negative predictive value ≥90% ruled out CSPH.A total of 836 patients with hepatitis C (n = 358), nonalcoholic steatohepatitis (NASH, n = 248), alcohol use (n = 203), and hepatitis B (n = 27) were evaluated. Portal hypertension prevalence was >90% in all cACLD etiologies, except for patients with NASH (60.9%), being even lower in obese patients with NASH (53.3%); these lower prevalences of portal hypertension in patients with NASH were maintained across different strata of LSM values. LSM ≥25 kPa was the best cutoff to rule in CSPH in alcoholic liver disease, chronic hepatitis B, chronic hepatitis C, and nonobese patients with NASH, whereas in obese NASH patients, the positive predictive value was only 62.8%. A new model for patients with NASH (ANTICIPATE-NASH model) to predict CSPH considering body mass index, LSM, and platelet count was developed, and a nomogram was constructed. LSM ≤15 kPa plus platelets ≥150 × 10/L ruled out CSPH in most etiologies.RESULTSA total of 836 patients with hepatitis C (n = 358), nonalcoholic steatohepatitis (NASH, n = 248), alcohol use (n = 203), and hepatitis B (n = 27) were evaluated. Portal hypertension prevalence was >90% in all cACLD etiologies, except for patients with NASH (60.9%), being even lower in obese patients with NASH (53.3%); these lower prevalences of portal hypertension in patients with NASH were maintained across different strata of LSM values. LSM ≥25 kPa was the best cutoff to rule in CSPH in alcoholic liver disease, chronic hepatitis B, chronic hepatitis C, and nonobese patients with NASH, whereas in obese NASH patients, the positive predictive value was only 62.8%. A new model for patients with NASH (ANTICIPATE-NASH model) to predict CSPH considering body mass index, LSM, and platelet count was developed, and a nomogram was constructed. LSM ≤15 kPa plus platelets ≥150 × 10/L ruled out CSPH in most etiologies.Patients with cACLD of NASH etiology, especially obese patients with NASH, present lower prevalences of portal hypertension compared with other cACLD etiologies. LSM ≥25 kPa is sufficient to rule in CSPH in most etiologies, including nonobese patients with NASH, but not in obese patients with NASH.DISCUSSIONPatients with cACLD of NASH etiology, especially obese patients with NASH, present lower prevalences of portal hypertension compared with other cACLD etiologies. LSM ≥25 kPa is sufficient to rule in CSPH in most etiologies, including nonobese patients with NASH, but not in obese patients with NASH. |
| Author | Schwabl, Philipp Rodrigues, Susana G. Ma, Mang M. Abraldes, Juan G. Stefanescu, Horia Scheiner, Bernhard Ferlitsch, Arnulf Procopet, Bogdan Mergeay-Fabre, Mayka Reiberger, Thomas Genescà, Joan Mandorfer, Mattias Semmler, Georg Tsochatzis, Emmanuel Augustin, Salvador Berzigotti, Annalisa Rosselli, Matteo Bureau, Christophe Guillaume, Maeva Bosch, Jaime Pons, Monica |
| Author_xml | – sequence: 1 givenname: Monica surname: Pons fullname: Pons, Monica organization: Liver Unit, Department of Internal Medicine, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Faculty of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain – sequence: 2 givenname: Salvador surname: Augustin fullname: Augustin, Salvador organization: Liver Unit, Department of Internal Medicine, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Faculty of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain;, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain – sequence: 3 givenname: Bernhard surname: Scheiner fullname: Scheiner, Bernhard organization: Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria;, Vienna Hepatic Hemodynamic Laboratory, Medical University of Vienna, Vienna, Austria – sequence: 4 givenname: Maeva surname: Guillaume fullname: Guillaume, Maeva organization: Service d'Hépatologie CHU Toulouse Rangueil, Institut Cardiomet et Université Paul Sabatier, Toulouse, France – sequence: 5 givenname: Matteo surname: Rosselli fullname: Rosselli, Matteo organization: UCL Institute for Liver and Digestive Health and Sheila Sherlock Liver Centre, Royal Free Hospital and UCL, London, United Kingdom – sequence: 6 givenname: Susana G. surname: Rodrigues fullname: Rodrigues, Susana G. organization: Swiss Liver Center, UVCM, Inselspital, Department of Biomedical Research, University of Bern, Bern, Switzerland – sequence: 7 givenname: Horia surname: Stefanescu fullname: Stefanescu, Horia organization: Liver Unit, Regional Institute of Gastroenterology and Hepatology “Octavian Fodor,” University of Medicine and Pharmacy “Iuliu Hatieganu,” Cluj-Napoca, Romania – sequence: 8 givenname: Mang M. surname: Ma fullname: Ma, Mang M. organization: Division of Gastroenterology (Liver Unit), University of Alberta, Edmonton, Canada – sequence: 9 givenname: Mattias surname: Mandorfer fullname: Mandorfer, Mattias organization: Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria;, Vienna Hepatic Hemodynamic Laboratory, Medical University of Vienna, Vienna, Austria – sequence: 10 givenname: Mayka surname: Mergeay-Fabre fullname: Mergeay-Fabre, Mayka organization: Service d'Hépatologie CHU Toulouse Rangueil, Institut Cardiomet et Université Paul Sabatier, Toulouse, France – sequence: 11 givenname: Bogdan surname: Procopet fullname: Procopet, Bogdan organization: Liver Unit, Regional Institute of Gastroenterology and Hepatology “Octavian Fodor,” University of Medicine and Pharmacy “Iuliu Hatieganu,” Cluj-Napoca, Romania – sequence: 12 givenname: Philipp surname: Schwabl fullname: Schwabl, Philipp organization: Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria;, Vienna Hepatic Hemodynamic Laboratory, Medical University of Vienna, Vienna, Austria – sequence: 13 givenname: Arnulf surname: Ferlitsch fullname: Ferlitsch, Arnulf organization: Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria;, Vienna Hepatic Hemodynamic Laboratory, Medical University of Vienna, Vienna, Austria;, Division of Internal Medicine II, Krankenhaus Barmherzige Brüder, Vienna, Austria – sequence: 14 givenname: Georg surname: Semmler fullname: Semmler, Georg organization: Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria;, Vienna Hepatic Hemodynamic Laboratory, Medical University of Vienna, Vienna, Austria – sequence: 15 givenname: Annalisa surname: Berzigotti fullname: Berzigotti, Annalisa organization: Swiss Liver Center, UVCM, Inselspital, Department of Biomedical Research, University of Bern, Bern, Switzerland;, Liver Unit, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain – sequence: 16 givenname: Emmanuel surname: Tsochatzis fullname: Tsochatzis, Emmanuel organization: UCL Institute for Liver and Digestive Health and Sheila Sherlock Liver Centre, Royal Free Hospital and UCL, London, United Kingdom – sequence: 17 givenname: Christophe surname: Bureau fullname: Bureau, Christophe organization: Service d'Hépatologie CHU Toulouse Rangueil, Institut Cardiomet et Université Paul Sabatier, Toulouse, France – sequence: 18 givenname: Thomas surname: Reiberger fullname: Reiberger, Thomas organization: Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria;, Vienna Hepatic Hemodynamic Laboratory, Medical University of Vienna, Vienna, Austria – sequence: 19 givenname: Jaime surname: Bosch fullname: Bosch, Jaime organization: Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain;, Swiss Liver Center, UVCM, Inselspital, Department of Biomedical Research, University of Bern, Bern, Switzerland;, Liver Unit, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain – sequence: 20 givenname: Juan G. surname: Abraldes fullname: Abraldes, Juan G. organization: Division of Gastroenterology (Liver Unit), University of Alberta, Edmonton, Canada – sequence: 21 givenname: Joan surname: Genescà fullname: Genescà, Joan organization: Liver Unit, Department of Internal Medicine, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Faculty of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain;, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/33982942$$D View this record in MEDLINE/PubMed https://hal.science/hal-04868138$$DView record in HAL |
| BookMark | eNp9kc1OGzEUha0KVALlEVpZ6qYshvpvPLa6itJCkKKWBRJLy2N7iKOJndpOJN6-hkCFssAbW9ffOVf3nlNwFGJwAHzG6BIziuR3vXq4RG-PlOwDmOC2Iw0iDB-BSS2SRpIOnYDTnFcI4ZZ07UdwQqkURDIyAcvfMfiw09nvHPzp9UOI2WcYB3gbU9EjnD9uXCouZB8D9AHe6uJdKBne-7KEs7je1D9dnIVTu9PB1MdsmaqpgYvqmappdjq7T-B40GN25y_3Gbi7-nU3mzeLP9c3s-miMUTw0gje99haYQi1AqGek85ay6V2EuOODww5pBkxgiHLBR0o6zlybGCmt1gYegYu9rZLPapN8mudHlXUXs2nC_VUQ0xwganY4cp-27ObFP9uXS5q7bNx46iDi9usSEs4RVzyrqJfD9BV3KZQB6lUyyTHnXgy_PJCbfu1s__7v667Aj_2gEkx5-QGZXypC42hJO1HhZF6DlfVcNVhuFXdHqhfG7yv-wdzXaZr |
| CitedBy_id | crossref_primary_10_1111_liv_15919 crossref_primary_10_1186_s13063_025_08818_6 crossref_primary_10_3390_cancers16162878 crossref_primary_10_3748_wjg_v30_i4_290 crossref_primary_10_1038_s41575_024_01031_x crossref_primary_10_14309_ajg_0000000000001887 crossref_primary_10_1097_HEP_0000000000001342 crossref_primary_10_3389_fmed_2023_1224506 crossref_primary_10_1097_HEP_0000000000001183 crossref_primary_10_1111_liv_15632 crossref_primary_10_1016_j_jhep_2025_04_008 crossref_primary_10_1080_17474124_2024_2358149 crossref_primary_10_3748_wjg_v31_i33_107408 crossref_primary_10_14366_usg_24219 crossref_primary_10_3390_diagnostics14070743 crossref_primary_10_1097_CLD_0000000000000114 crossref_primary_10_1097_TXD_0000000000001517 crossref_primary_10_1016_j_jhep_2022_12_005 crossref_primary_10_1016_j_clinre_2023_102123 crossref_primary_10_1016_S2468_1253_23_00150_4 crossref_primary_10_1111_apt_18054 crossref_primary_10_1097_HC9_0000000000000524 crossref_primary_10_1097_HEP_0000000000000647 crossref_primary_10_3390_diagnostics13162631 crossref_primary_10_1016_j_rgmxen_2024_05_001 crossref_primary_10_1007_s10620_024_08272_5 crossref_primary_10_1371_journal_pone_0303971 crossref_primary_10_14309_ajg_0000000000001873 crossref_primary_10_1097_HEP_0000000000001117 crossref_primary_10_1016_j_gastre_2024_502208 crossref_primary_10_1007_s12072_024_10774_3 crossref_primary_10_3390_diagnostics12102373 crossref_primary_10_1097_HEP_0000000000000263 crossref_primary_10_1111_jgh_15819 crossref_primary_10_1007_s10620_025_09193_7 crossref_primary_10_1002_poh2_70002 crossref_primary_10_1159_000539371 crossref_primary_10_1007_s12072_021_10280_w crossref_primary_10_1080_17474124_2025_2548526 crossref_primary_10_1080_17474124_2025_2530605 crossref_primary_10_1002_poh2_70004 crossref_primary_10_1016_j_amjmed_2023_12_001 crossref_primary_10_1111_apt_18203 crossref_primary_10_1016_j_jhep_2021_10_008 crossref_primary_10_1016_j_gastre_2022_11_006 crossref_primary_10_1016_j_dld_2022_10_009 crossref_primary_10_1007_s00063_021_00845_w crossref_primary_10_1007_s12072_024_10657_7 crossref_primary_10_1016_j_jdiacomp_2025_108978 crossref_primary_10_1007_s11739_022_03139_x crossref_primary_10_1016_j_cgh_2023_12_016 crossref_primary_10_1177_17562848221101712 crossref_primary_10_1053_j_gastro_2025_02_034 crossref_primary_10_1007_s00508_023_02229_w crossref_primary_10_1007_s41971_022_00138_9 crossref_primary_10_1111_liv_70311 crossref_primary_10_2337_dci24_0094 crossref_primary_10_1007_s00535_024_02182_z crossref_primary_10_1111_apt_18113 crossref_primary_10_1016_j_cld_2024_03_010 crossref_primary_10_1080_17843286_2025_2466011 crossref_primary_10_1136_egastro_2025_100196 crossref_primary_10_1007_s10620_021_07277_8 crossref_primary_10_1016_j_jceh_2022_03_002 crossref_primary_10_1136_bmjopen_2023_081623 crossref_primary_10_1371_journal_pone_0301416 crossref_primary_10_1016_j_tvir_2025_101052 crossref_primary_10_1016_j_cgh_2024_03_028 crossref_primary_10_1016_j_jhepr_2025_101399 crossref_primary_10_1016_j_ultrasmedbio_2024_03_013 crossref_primary_10_1038_s41598_020_80136_0 crossref_primary_10_1007_s12072_021_10188_5 crossref_primary_10_1097_ACO_0000000000001527 crossref_primary_10_1007_s11894_025_00976_6 crossref_primary_10_1016_j_aohep_2023_101180 crossref_primary_10_1080_17474124_2023_2196402 crossref_primary_10_1007_s00261_024_04309_5 crossref_primary_10_1056_NEJMe2110989 crossref_primary_10_1152_ajpgi_00409_2024 crossref_primary_10_1016_j_cld_2024_03_002 crossref_primary_10_1016_j_cgh_2023_03_019 crossref_primary_10_1007_s10620_022_07778_0 crossref_primary_10_1097_HEP_0000000000000456 crossref_primary_10_1111_eci_13750 crossref_primary_10_1002_hep4_2091 crossref_primary_10_1007_s11901_022_00584_2 crossref_primary_10_1007_s11901_024_00661_8 crossref_primary_10_1016_j_cgh_2022_09_032 crossref_primary_10_1111_hepr_14028 crossref_primary_10_1111_liv_15561 crossref_primary_10_3350_cmh_2024_0246 crossref_primary_10_3389_fmed_2022_844558 crossref_primary_10_1097_CM9_0000000000003785 crossref_primary_10_1097_HC9_0000000000000609 crossref_primary_10_14309_ajg_0000000000001290 crossref_primary_10_3350_cmh_2022_0181 crossref_primary_10_1007_s11901_023_00609_4 crossref_primary_10_1016_j_cgh_2024_05_012 crossref_primary_10_1016_j_gastrohep_2024_502208 crossref_primary_10_1007_s10620_024_08270_7 crossref_primary_10_1016_j_ejim_2025_04_028 crossref_primary_10_1097_HEP_0000000000000342 crossref_primary_10_1007_s10396_022_01239_x crossref_primary_10_1016_j_amjms_2024_01_009 crossref_primary_10_1136_gutjnl_2025_334981 crossref_primary_10_1016_j_jhep_2024_09_014 crossref_primary_10_1111_liv_16143 crossref_primary_10_1111_apt_70215 crossref_primary_10_1016_j_cld_2023_01_019 crossref_primary_10_1016_j_jhep_2021_12_037 crossref_primary_10_1016_j_jhep_2024_04_031 crossref_primary_10_1111_jgh_15863 crossref_primary_10_1016_S2468_1253_24_00234_6 crossref_primary_10_1097_HEP_0000000000000618 crossref_primary_10_3390_diagnostics12020441 crossref_primary_10_4254_wjh_v17_i6_104761 crossref_primary_10_1056_NEJMe2505834 crossref_primary_10_1038_s41575_024_00955_8 crossref_primary_10_3350_cmh_2024_0898 crossref_primary_10_1016_j_igie_2024_04_011 crossref_primary_10_3390_diagnostics13040788 crossref_primary_10_1007_s12072_023_10570_5 crossref_primary_10_1016_j_clinre_2022_101925 crossref_primary_10_14309_ajg_0000000000001267 crossref_primary_10_1002_ueg2_12491 crossref_primary_10_1016_j_jhep_2021_05_025 crossref_primary_10_1111_apt_17626 crossref_primary_10_3389_fmed_2024_1420157 crossref_primary_10_1111_apt_17866 crossref_primary_10_1016_j_gastrohep_2022_11_005 crossref_primary_10_1016_j_rgmxen_2025_09_007 crossref_primary_10_1016_j_ejrad_2023_110841 crossref_primary_10_1016_j_cgh_2023_08_004 crossref_primary_10_1097_HEP_0000000000000829 crossref_primary_10_3389_fmed_2022_960316 crossref_primary_10_1007_s00108_022_01427_4 crossref_primary_10_1016_j_jhep_2023_12_028 crossref_primary_10_1097_HEP_0000000000000843 crossref_primary_10_1097_HEP_0000000000000844 crossref_primary_10_3350_cmh_2022_0414 crossref_primary_10_1007_s12328_022_01752_z crossref_primary_10_1097_HEP_0000000000000841 crossref_primary_10_3390_life13010132 crossref_primary_10_1097_HEP_0000000000000323 crossref_primary_10_1186_s12903_025_05765_1 crossref_primary_10_3390_cancers15092480 crossref_primary_10_1016_j_ejso_2023_107313 crossref_primary_10_1053_j_gastro_2023_06_013 crossref_primary_10_1111_liv_16241 crossref_primary_10_1111_apt_17699 crossref_primary_10_1016_j_rgmx_2025_03_003 crossref_primary_10_3390_ijms221910372 crossref_primary_10_1002_hep4_1855 crossref_primary_10_1111_jgh_15840 crossref_primary_10_1016_j_jceh_2023_04_008 crossref_primary_10_1016_j_cgh_2024_10_020 crossref_primary_10_1016_j_jceh_2022_09_003 crossref_primary_10_1007_s10620_021_07283_w crossref_primary_10_2337_dc24_1341 crossref_primary_10_1097_MEG_0000000000003045 crossref_primary_10_3390_jcm13247719 |
| Cites_doi | 10.1038/nrgastro.2009.149 10.1002/hep.27844 10.1111/j.1365-2036.2008.03825.x 10.1111/liv.13943 10.1016/j.jhep.2011.01.051 10.1002/hep.29363 10.1111/liv.12623 10.1007/s00535-011-0517-4 10.1007/s00508-012-0190-5 10.1016/j.dld.2015.02.001 10.1016/j.jhep.2015.05.022 10.1016/j.jhep.2011.10.007 10.1016/j.jhep.2016.05.027 10.1016/j.jhep.2013.10.027 10.1136/gutjnl-2018-317334 10.14309/ajg.0000000000000153 10.1111/j.1365-2036.2008.03701.x 10.1111/apt.14529 10.1111/apt.14522 10.1002/hep.28824 10.1053/j.gastro.2019.01.042 10.1053/j.gastro.2012.10.001 10.1016/j.cgh.2012.05.008 10.1016/j.cgh.2018.04.043 10.1002/sim.5941 10.1016/S0140-6736(18)31875-0 |
| ContentType | Journal Article |
| Copyright | 2021 by The American College of Gastroenterology Distributed under a Creative Commons Attribution 4.0 International License |
| Copyright_xml | – notice: 2021 by The American College of Gastroenterology – notice: Distributed under a Creative Commons Attribution 4.0 International License |
| DBID | AAYXX CITATION NPM 3V. 7X7 7XB 88E 8FI 8FJ 8FK ABUWG AFKRA BENPR CCPQU FYUFA GHDGH K9. M0S M1P PHGZM PHGZT PJZUB PKEHL PPXIY PQEST PQQKQ PQUKI PRINS 7X8 1XC |
| DOI | 10.14309/ajg.0000000000000994 |
| DatabaseName | CrossRef PubMed ProQuest Central (Corporate) Health & Medical Collection ProQuest Central (purchase pre-March 2016) Medical Database (Alumni Edition) ProQuest Hospital Collection Hospital Premium Collection (Alumni Edition) ProQuest Central (Alumni) (purchase pre-March 2016) ProQuest Central (Alumni) ProQuest Central UK/Ireland ProQuest Central ProQuest One Community College Health Research Premium Collection Health Research Premium Collection (Alumni) ProQuest Health & Medical Complete (Alumni) ProQuest Health & Medical Collection PML(ProQuest Medical Library) ProQuest Central Premium ProQuest One Academic ProQuest Health & Medical Research Collection ProQuest One Academic Middle East (New) ProQuest One Health & Nursing ProQuest One Academic Eastern Edition (DO NOT USE) ProQuest One Academic (retired) ProQuest One Academic UKI Edition ProQuest Central China MEDLINE - Academic Hyper Article en Ligne (HAL) |
| DatabaseTitle | CrossRef PubMed ProQuest One Academic Middle East (New) ProQuest One Academic Eastern Edition ProQuest Health & Medical Complete (Alumni) ProQuest Central (Alumni Edition) ProQuest One Community College ProQuest One Health & Nursing ProQuest Hospital Collection Health Research Premium Collection (Alumni) ProQuest Central China ProQuest Hospital Collection (Alumni) ProQuest Central ProQuest Health & Medical Complete ProQuest Health & Medical Research Collection Health Research Premium Collection ProQuest Medical Library ProQuest One Academic UKI Edition Health and Medicine Complete (Alumni Edition) Health & Medical Research Collection ProQuest Central (New) ProQuest One Academic ProQuest One Academic (New) ProQuest Medical Library (Alumni) ProQuest Central (Alumni) MEDLINE - Academic |
| DatabaseTitleList | ProQuest One Academic Middle East (New) PubMed MEDLINE - Academic |
| Database_xml | – sequence: 1 dbid: NPM name: PubMed url: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: BENPR name: ProQuest Central url: https://www.proquest.com/central sourceTypes: Aggregation Database |
| DeliveryMethod | fulltext_linktorsrc |
| Discipline | Medicine |
| EISSN | 1572-0241 |
| EndPage | 732 |
| ExternalDocumentID | oai:HAL:hal-04868138v1 33982942 10_14309_ajg_0000000000000994 |
| Genre | Journal Article |
| GeographicLocations | France |
| GeographicLocations_xml | – name: France |
| GroupedDBID | --- --K -Q- .55 .GJ 0R~ 123 1B1 1OC 23M 31~ 36B 39C 3O- 4.4 4G. 53G 5RE 5VS 6J9 70F 7X7 88E 8FI 8FJ 8GM 9DU AAAAV AAEDT AAGIX AAHPQ AAIQE AAJCS AALRI AAMOA AAQFI AAQKA AAQQT AAQXK AASCR AASXQ AAXUO AAYXX ABASU ABDIG ABJNI ABLJU ABOCM ABPXF ABUWG ABVCZ ABWVN ABXYN ABZZY ACBKD ACGFO ACGFS ACILI ACKTT ACLDA ACNWC ACOAL ACRPL ACXJB ACXQS ACZKN ADBBV ADFRT ADGGA ADHPY ADKSD ADMUD ADNKB ADNMO ADSXY AEBDS AEETU AENEX AEXYK AFBFQ AFBPY AFDTB AFEBI AFEXH AFFHD AFFNX AFKRA AFNMH AFUWQ AGAYW AGQPQ AHMBA AHOMT AHQNM AHQVU AHSBF AHVBC AI. AINUH AJAOE AJCLO AJIOK AJNWD AJRNO AJZMW AKCTQ AKRWK AKULP ALKUP ALMA_UNASSIGNED_HOLDINGS ALMTX AMJPA AMKUR AMNEI AOHHW AOQMC BENPR BPHCQ BVXVI BYPQX C45 CAG CCPQU CITATION COF CS3 DIWNM EBS EE. EEVPB EJD EMB EMOBN ERAAH F5P FCALG FDB FDQFY FEDTE FGOYB FYUFA GNXGY GQDEL HLJTE HMCUK HVGLF HZ~ IHE IKREB IKYAY IPNFZ JSO LH4 LW6 M1P M41 N4W NQ- O9- ODMTH OPUJH OVD OVDNE P0W P2P PHGZM PHGZT PJZUB PPXIY PQQKQ PROAC PSQYO R2- RIG RLZ RNT RNTTT ROL RPZ SEW SJN SSZ SV3 TEORI TSPGW UDS UKHRP VH1 X7M XIF XPP ZGI ZXP ZZMQN ABAWZ ALIPV NPM 3V. 7XB 8FK K9. PKEHL PQEST PQUKI PRINS 7X8 PUEGO 1XC |
| ID | FETCH-LOGICAL-c286t-86bb1dd8c23d800b627ddd69ae91176f40e0a42c840d683f34b60e4f4cbd18c3 |
| IEDL.DBID | 7X7 |
| ISSN | 0002-9270 1572-0241 |
| IngestDate | Sat Oct 25 07:07:19 EDT 2025 Wed Oct 01 14:04:13 EDT 2025 Tue Oct 07 06:55:37 EDT 2025 Mon Jul 21 05:55:47 EDT 2025 Sat Nov 29 07:40:50 EST 2025 Tue Nov 18 22:18:23 EST 2025 |
| IsPeerReviewed | true |
| IsScholarly | true |
| Issue | 4 |
| Language | English |
| License | Distributed under a Creative Commons Attribution 4.0 International License: http://creativecommons.org/licenses/by/4.0 |
| LinkModel | DirectLink |
| MergedId | FETCHMERGED-LOGICAL-c286t-86bb1dd8c23d800b627ddd69ae91176f40e0a42c840d683f34b60e4f4cbd18c3 |
| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 |
| PMID | 33982942 |
| PQID | 2554961781 |
| PQPubID | 2041977 |
| PageCount | 10 |
| ParticipantIDs | hal_primary_oai_HAL_hal_04868138v1 proquest_miscellaneous_2526306967 proquest_journals_2554961781 pubmed_primary_33982942 crossref_citationtrail_10_14309_ajg_0000000000000994 crossref_primary_10_14309_ajg_0000000000000994 |
| PublicationCentury | 2000 |
| PublicationDate | 2021-04-01 |
| PublicationDateYYYYMMDD | 2021-04-01 |
| PublicationDate_xml | – month: 04 year: 2021 text: 2021-04-01 day: 01 |
| PublicationDecade | 2020 |
| PublicationPlace | United States |
| PublicationPlace_xml | – name: United States – name: New York |
| PublicationTitle | The American journal of gastroenterology |
| PublicationTitleAlternate | Am J Gastroenterol |
| PublicationYear | 2021 |
| Publisher | Wolters Kluwer Health Medical Research, Lippincott Williams & Wilkins Lippincott, Williams & Wilkins |
| Publisher_xml | – name: Wolters Kluwer Health Medical Research, Lippincott Williams & Wilkins – name: Lippincott, Williams & Wilkins |
| References | Siddiqui (R25-20250804) 2019; 17 Berzigotti (R4-20250804) 2013; 144 Robic (R9-20250804) 2011; 55 Mandorfer (R11-20250804) 2018; 47 Scheiner (R14-20250804) 2019; 39 Reiberger (R16-20250804) 2012; 47 Eddowes (R21-20250804) 2019; 156 Francque (R26-20250804) 2010; 22 Petta (R22-20250804) 2015; 62 Abraldes (R5-20250804) 2016; 64 Reiberger (R15-20250804) 2012; 124 Myers (R24-20250804) 2012; 56 de Franchis (R1-20250804) 2015; 63 Augustin (R10-20250804) 2014; 60 Karlas (R23-20250804) 2018; 47 Bureau (R3-20250804) 2008; 27 Mandorfer (R12-20250804) 2016; 65 Procopet (R8-20250804) 2015; 47 Wong (R20-20250804) 2019; 68 Bosch (R17-20250804) 2009; 6 Mendes (R27-20250804) 2012; 10 Villanueva (R6-20250804) 2019; 393 Augustin (R7-20250804) 2017; 66 Austin (R18-20250804) 2014; 33 Petta (R19-20250804) 2019; 114 Schwabl (R13-20250804) 2015; 35 Lemoine (R2-20250804) 2008; 28 |
| References_xml | – volume: 6 start-page: 573 year: 2009 ident: R17-20250804 article-title: The clinical use of HVPG measurements in chronic liver disease publication-title: Nat Rev Gastroenterol Hepatol doi: 10.1038/nrgastro.2009.149 – volume: 62 start-page: 1101 year: 2015 ident: R22-20250804 article-title: The severity of steatosis influences liver stiffness measurement in patients with nonalcoholic fatty liver disease publication-title: Hepatology doi: 10.1002/hep.27844 – volume: 28 start-page: 1102 year: 2008 ident: R2-20250804 article-title: Liver stiffness measurement as a predictive tool of clinically significant portal hypertension in patients with compensated hepatitis C virus or alcohol-related cirrhosis publication-title: Aliment Pharmacol Ther doi: 10.1111/j.1365-2036.2008.03825.x – volume: 39 start-page: 127 year: 2019 ident: R14-20250804 article-title: Controlled attenuation parameter does not predict hepatic decompensation in patients with advanced chronic liver disease publication-title: Liver Int doi: 10.1111/liv.13943 – volume: 55 start-page: 1017 year: 2011 ident: R9-20250804 article-title: Liver stiffness accurately predicts portal hypertension related complications in patients with chronic liver disease: A prospective study publication-title: J Hepatol doi: 10.1016/j.jhep.2011.01.051 – volume: 66 start-page: 1980 year: 2017 ident: R7-20250804 article-title: Expanding the Baveno VI criteria for the screening of varices in patients with compensated advanced chronic liver disease publication-title: Hepatology doi: 10.1002/hep.29363 – volume: 35 start-page: 381 year: 2015 ident: R13-20250804 article-title: New reliability criteria for transient elastography increase the number of accurate measurements for screening of cirrhosis and portal hypertension publication-title: Liver Int doi: 10.1111/liv.12623 – volume: 47 start-page: 561 year: 2012 ident: R16-20250804 article-title: Non-selective β-blockers improve the correlation of liver stiffness and portal pressure in advanced cirrhosis publication-title: J Gastroenterol doi: 10.1007/s00535-011-0517-4 – volume: 124 start-page: 395 year: 2012 ident: R15-20250804 article-title: Noninvasive screening for liver fibrosis and portal hypertension by transient elastography—A large single center experience publication-title: Wien Klin Wochenschr doi: 10.1007/s00508-012-0190-5 – volume: 47 start-page: 411 year: 2015 ident: R8-20250804 article-title: Serum tests, liver stiffness and artificial neural networks for diagnosing cirrhosis and portal hypertension publication-title: Dig Liver Dis doi: 10.1016/j.dld.2015.02.001 – volume: 63 start-page: 743 year: 2015 ident: R1-20250804 article-title: Expanding consensus in portal hypertension: Report of the Baveno VI Consensus Workshop: Stratifying risk and individualizing care for portal hypertension publication-title: J Hepatol doi: 10.1016/j.jhep.2015.05.022 – volume: 56 start-page: 564 year: 2012 ident: R24-20250804 article-title: Discordance in fibrosis staging between liver biopsy and transient elastography using the FibroScan XL probe publication-title: J Hepatol doi: 10.1016/j.jhep.2011.10.007 – volume: 65 start-page: 692 year: 2016 ident: R12-20250804 article-title: Sustained virologic response to interferon-free therapies ameliorates HCV-induced portal hypertension publication-title: J Hepatol doi: 10.1016/j.jhep.2016.05.027 – volume: 60 start-page: 561 year: 2014 ident: R10-20250804 article-title: Detection of early portal hypertension with routine data and liver stiffness in patients with asymptomatic liver disease: A prospective study publication-title: J Hepatol doi: 10.1016/j.jhep.2013.10.027 – volume: 68 start-page: 2057 year: 2019 ident: R20-20250804 article-title: Unified interpretation of liver stiffness measurement by M and XL probes in non-alcoholic fatty liver disease publication-title: Gut doi: 10.1136/gutjnl-2018-317334 – volume: 114 start-page: 916 year: 2019 ident: R19-20250804 article-title: Impact of obesity and alanine aminotransferase levels on the diagnostic accuracy for advanced liver fibrosis of noninvasive tools in patients with nonalcoholic fatty liver disease publication-title: Am J Gastroenterol doi: 10.14309/ajg.0000000000000153 – volume: 27 start-page: 1261 year: 2008 ident: R3-20250804 article-title: Transient elastography accurately predicts presence of significant portal hypertension in patients with chronic liver disease publication-title: Aliment Pharmacol Ther doi: 10.1111/j.1365-2036.2008.03701.x – volume: 47 start-page: 989 year: 2018 ident: R23-20250804 article-title: Impact of controlled attenuation parameter on detecting fibrosis using liver stiffness measurement publication-title: Aliment Pharmacol Ther doi: 10.1111/apt.14529 – volume: 22 start-page: 1449 year: 2010 ident: R26-20250804 article-title: Noncirrhotic human nonalcoholic fatty liver disease induces portal hypertension in relation to the histological degree of steatosis publication-title: Eur J Gastroenterol Hepatol – volume: 47 start-page: 980 year: 2018 ident: R11-20250804 article-title: Von Willebrand factor indicates bacterial translocation, inflammation, and procoagulant imbalance and predicts complications independently of portal hypertension severity publication-title: Aliment Pharmacol Ther doi: 10.1111/apt.14522 – volume: 64 start-page: 2173 year: 2016 ident: R5-20250804 article-title: Noninvasive tools and risk of clinically significant portal hypertension and varices in compensated cirrhosis: The “Anticipate” study publication-title: Hepatology doi: 10.1002/hep.28824 – volume: 156 start-page: 1717 year: 2019 ident: R21-20250804 article-title: Accuracy of FibroScan controlled attenuation parameter and liver stiffness measurement in assessing steatosis and fibrosis in patients with nonalcoholic fatty liver disease publication-title: Gastroenterology doi: 10.1053/j.gastro.2019.01.042 – volume: 144 start-page: 102 year: 2013 ident: R4-20250804 article-title: Elastography, spleen size, and platelet count identify portal hypertension in patients with compensated cirrhosis publication-title: Gastroenterology doi: 10.1053/j.gastro.2012.10.001 – volume: 10 start-page: 1028 year: 2012 ident: R27-20250804 article-title: Prevalence and indicators of portal hypertension in patients with nonalcoholic fatty liver disease publication-title: Clin Gastroenterol Hepatol doi: 10.1016/j.cgh.2012.05.008 – volume: 17 start-page: 156 year: 2019 ident: R25-20250804 article-title: Vibration-controlled transient elastography to assess fibrosis and steatosis in patients with nonalcoholic fatty liver disease publication-title: Clin Gastroenterol Hepatol doi: 10.1016/j.cgh.2018.04.043 – volume: 33 start-page: 517 year: 2014 ident: R18-20250804 article-title: Graphical assessment of internal and external calibration of logistic regression models by using loess smoothers publication-title: Stat Med doi: 10.1002/sim.5941 – volume: 393 start-page: 1597 year: 2019 ident: R6-20250804 article-title: β blockers to prevent decompensation of cirrhosis in patients with clinically significant portal hypertension (PREDESCI): A randomised, double-blind, placebo-controlled, multicentre trial publication-title: Lancet doi: 10.1016/S0140-6736(18)31875-0 |
| SSID | ssj0015275 |
| Score | 2.6793258 |
| Snippet | We aimed to explore the prevalence of portal hypertension in the most common etiologies of patients with compensated advanced chronic liver disease (cACLD) and... INTRODUCTION:We aimed to explore the prevalence of portal hypertension in the most common etiologies of patients with compensated advanced chronic liver... INTRODUCTION: We aimed to explore the prevalence of portal hypertension in the most common etiologies of patients with compensated advanced chronic liver... |
| SourceID | hal proquest pubmed crossref |
| SourceType | Open Access Repository Aggregation Database Index Database Enrichment Source |
| StartPage | 723 |
| SubjectTerms | Classification Etiology Fatty liver Gastroenterology Hepatitis C Hypertension Life Sciences Liver diseases Nomograms Software |
| Title | Noninvasive Diagnosis of Portal Hypertension in Patients With Compensated Advanced Chronic Liver Disease |
| URI | https://www.ncbi.nlm.nih.gov/pubmed/33982942 https://www.proquest.com/docview/2554961781 https://www.proquest.com/docview/2526306967 https://hal.science/hal-04868138 |
| Volume | 116 |
| hasFullText | 1 |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| journalDatabaseRights | – providerCode: PRVPQU databaseName: Health & Medical Collection customDbUrl: eissn: 1572-0241 dateEnd: 20241209 omitProxy: false ssIdentifier: ssj0015275 issn: 0002-9270 databaseCode: 7X7 dateStart: 20190101 isFulltext: true titleUrlDefault: https://search.proquest.com/healthcomplete providerName: ProQuest – providerCode: PRVPQU databaseName: ProQuest Central customDbUrl: eissn: 1572-0241 dateEnd: 20241209 omitProxy: false ssIdentifier: ssj0015275 issn: 0002-9270 databaseCode: BENPR dateStart: 20190101 isFulltext: true titleUrlDefault: https://www.proquest.com/central providerName: ProQuest |
| link | http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV1Lb9QwEB7RFqFeeFMCpTKIa2jseP04oQVa7WFZrVAl9hb5kbCLUFI22_39eBInCCTgQA45xI9EmfH4G_vzDMBrYxBFqDwVTpqUCx7sYMWz1DorqaHSVlWXtWQuFwu1WullXHBrI61ysImdofaNwzXy8wB9ucbzbPTt9fcUs0bh7mpMoXEAR5g2G_VcrkaHCzO2Tgb4q5nM4gkenmf63Hz90scuHC6t-S9z08EamZF_gp3d9HN5738__D7cjcCTTHtNeQC3yvoh3PkYt9YfwXqBC7N7g3R28qEn4G1a0lSkJ5uSWfBYtx3fvanJpibLPiJrSz5vdmuCdiWUBeTqyTTyCkiMvEvmSP4InXZ7QY_h6vLi6v0sjWkYUseU2KVKWEu9V47lPsBLK5j03guM6k2pFEGyZWY4c8FV9ELlVc6tyEpecWc9VS5_Aod1U5dPgQTJm0lmMu-DF1Z6ZyeZqILDNpHMm4BDEuDD_y9cDFGOmTK-FeiqoNiKILbid7El8GZsdt3H6PhXg1dBuGNdjLA9m84LfIYRCBXN1Z4mcDrIs4jjui1-CjOBl2NxGJG4zWLqsrnBOkwER0wLmcBJrzPjq_JcK6Y5e_b3zp_DMUPuTMcQOoXD3famfAG33X63abdnnZJ3d3UGR-8uFstPPwDavAJ_ |
| linkProvider | ProQuest |
| linkToHtml | http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMw1V1Lb9QwEB61BQEX3o9AAYPgmDZxvLZzQGhFqbZquuphJfYWOXbCblUlZbNdxI_iPzKTFwIJOPVAjontPPx5Mp_9eQbgjTHkRejIl1YZX0iBdrAQgZ_ZTIUmVFlRNFlLEjWd6vk8Pt2C7_1eGJJV9jaxMdSusjRHvo-ur4hpP1v4_uKLT1mjaHW1T6HRwuI4__YVKVv97ugA-_ct54cfZx8mfpdVwLdcy7WvZZaFzmnLI4feUia5cs5JClIdhkrig-aBEdwi83FSR0UkMhnkohA2c6G2ETa7DdfQjCviemo-8DtKEDvqve2Yq6DbMCSiIN43Z5_bUIn9Ecfil1_h9oKEmH_ycpu_3eGd_-w73YXbnVvNxu04uAdbeXkfbpx0woEHsJjStPPGkFifHbTywmXNqoK1Ulo2QT6-atT8VcmWJTtt483W7NNyvWBkNfEa-uWOjTvVBOviCrOEpC3YaLPS9RBmV_Gaj2CnrMr8CTDEtRkFJnAOOWbubDYKZIF0dKS4M-hleSD67k5tF4Cd8oCcp0TECCUpoiT9HSUe7A3VLtoIJP-q8BqxNJSl-OGTcZLSOYqvqMNIb0IPdnv4pJ3VqtOf2PHg1XAZ7Q0tIpkyry6pDJdIM2OpPHjcQnS4VRTFmseCP_174y_h5mR2kqTJ0fT4GdzipBJqtFC7sLNeXebP4brdrJf16kUzvhikV4zTHyqUXIE |
| linkToPdf | http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMw1V1Lb9NAEB61Kap64f0wFFgQHE3s9XrXPiAUSKNUDVaEKtGbtd61SSpklyQN4qfx75jxC4EEnHrAR6-9fn2e_Wbn2xmAF1oTi4gCVxqlXSEF2sFCeG5mMuVrX2VFUVctmakkic7O4vkOfO_WwpCssrOJtaG2laE58iFSXxHTejZ_WLSyiPl48ubii0sVpCjS2pXTaCBykn_7iu7b-vXxGL_1S84nR6fvpm5bYcA1PJIbN5JZ5lsbGR5YZE6Z5MpaKylhte8riTede1pwg16QlVFQBCKTXi4KYTLrRybAbndhTyHHEAPYe3uUzD_0IYyQq7Dj3jFXXrt8SARePNTnn5rEid0Wx-KXgXF3QbLMP3Heeuyb3PiP39pNuN4SbjZq_pBbsJOXt2H_fSspuAOLhCakt5pk_GzcCA-Xa1YVrBHZsil66qta51-VbFmyeZOJds0-LjcLRvYU25CxWzZq9RSszTjMZiR6wU7rGNhdOL2Kx7wHg7Iq8wfAEPE69LRnLXqfuTVZ6MkCHdVQcauRfzkguk-fmjY1O1UI-ZySi0aISREx6e-IceBVf9pFk5vkXyc8R1z1x1Jm8eloltI-yrwY-UG09R047KCUtvZsnf7EkQPP-ma0RBRe0mVeXdIxXKIDGkvlwP0Grv2lgiCOeCz4w793_hT2EZ7p7Dg5eQQHnORDtUjqEAab1WX-GK6Z7Wa5Xj1pfzYG6RUD9QebP2ah |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Noninvasive+Diagnosis+of+Portal+Hypertension+in+Patients+With+Compensated+Advanced+Chronic+Liver+Disease&rft.jtitle=The+American+journal+of+gastroenterology&rft.au=Pons%2C+Monica&rft.au=Augustin%2C+Salvador&rft.au=Scheiner%2C+Bernhard&rft.au=Guillaume%2C+Maeva&rft.date=2021-04-01&rft.eissn=1572-0241&rft.volume=116&rft.issue=4&rft.spage=723&rft_id=info:doi/10.14309%2Fajg.0000000000000994&rft_id=info%3Apmid%2F33982942&rft.externalDocID=33982942 |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0002-9270&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0002-9270&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0002-9270&client=summon |